Talk:Multiple sclerosis

What's wrong with Pogoda et al.

@Zefr, this diff removed Pogoda et al. Curious to know why.

References

Dominic Mayers (talk) 17:44, 18 May 2026 (UTC)

1. It's not a clinical presentation, and doesn't fall within high evidence quality on WP:MEDASSESS, left pyramid

2. It's full of conjecture about MS mechanisms and unestablished biomarkers from lab studies or early-stage human research

3. It was used to reference general cognitive deficiencies better sourced to more basic clinical summaries

4. As a long complex report based on biochemistry and molecular mechanisms, it's unlikely to be an easy source for common users to read

4. By script detection, it's a red flag source as a Frontiers publication: #2 among dubious publishers on WP:CITEWATCH (see disclaimer). Zefr (talk) 18:23, 18 May 2026 (UTC)

I should consider the arguments in favor of these four points, but I have some preliminary questions. First, does the paper verify the content of the article it refers to? If not, these four points are superfluous and I would not consider them: the reference is not justified if it does not fulfill its purpose. If it does, the fact that it is the oldest of the proposed references suggests that a more thorough investigation of the original sources might be necessary. Dominic Mayers (talk) 22:32, 18 May 2026 (UTC)

Referring to point #3 above, Special:Diff/1354933122 applied the general clinical short reviews by NINDS, Tafti (StatPearls CME), and the UK MSS to cover the various symptoms. I suggest these sources are preferable to the general reader over the primary research and conjecture on mechanisms that might appeal to MS researchers. Zefr (talk) 01:35, 19 May 2026 (UTC)

I assume that you refer to "primary research and conjecture on mechanisms" that go beyond what is stated in the article. Am I right ? Dominic Mayers (talk) 02:58, 19 May 2026 (UTC)

@Zefr, looking at your recent edits, it is clear that you are moving toward prioritizing StatPearls as a source. It will be good not to remove minority opinions that are published in reliable sources in that process, not sources that guaranty truth, because this is an area where hypotheses are normal. The subject seems to be of a kind where multiple exploratory and opposite view points are possible. Dominic Mayers (talk) 09:21, 19 May 2026 (UTC)

StatPears itself is not a top-quality source. It's useable, but it will have more errors than a review in Nature Medicine or JAMA. It's often written by people with more general medical knowledge, not the top people in the field. Frontiers in Molecular Neuroscience is a Q2 journal, and in general Frontiers and MDPI are borderline (not 100% predatory, only special collections should be avoided a priori). Their peer review is weak. When we're talking about hypotheses, it's best to avoid them and use the highest-quality sources to know what is and what isn't due. Lower-quality sources might give too much prominence to quite niche hypotheses, whereas the big overview articles are more balanced. We don't seem to be citing Attfield et al, 2022 yet, which might be a starting point for talking about the immune dysfunction in MS (not yet read it, but top journal). —Femke 🐦 (talk) 09:52, 19 May 2026 (UTC)

I took a critical eye of the 2024 Tafti-StatPearls short review, and reused it as a generally accurate, straightforward 'state of science' that is readable for a common encyclopedia user, WP:WFTWA (picture teens-30s).

In addition to Attfield, this 2025 Australian review is a good analysis of MS issues, although it presents appropriate caveats of "precise pathogenesis remains unclear, and current evidence does not fully support its classification as a typical autoimmune disorder", and a 'Treatment' section displaying the frustrating, slow-moving research for reliable biomarkers and therapies.

My impression is that the article is a case of not being able to see the details of a tree because the forest is so dense. Zefr (talk) 17:45, 19 May 2026 (UTC)

You are not alone in favoring the principle of basing an article on a few notable sources, which are therefore frequently cited, while the others serve only peripheral purposes. Your recent edits have allowed Tafti-StatPearls to achieve this status of a highly cited source. I am not sufficiently familiar with medical research to comment on this. My concern relates to the principle of neutral point of view, which stipulates that all (significant) viewpoints must be presented. It seems that, in this specific case, very few medical claims should be presented as absolute truths, and that all significant viewpoints should be presented, in accordance with this principle. However, I leave it to the experts in the field to determine how to apply this principle. Dominic Mayers (talk) 20:50, 19 May 2026 (UTC)

@Zefr: now I've become more familiar with the literature, it's clear that the StatsPearl source has quite a number of outdated elements and errors. For instance, it talks about including progressive relapsing MS (term was phased out in 2013 if I understand it correctly). So I'll be replacing it. I notice the source has been added to replace other sources without a proper verification that it fully supports the preceding text, e.g. . When replacing sources, please do update the surrounding text. In solidarity, —Femke (talk) 🐦 20:55, 20 September 2026 (UTC)

Infobox image

Myelin_sheath_damage_in_multiple_sclerosis

The current infobox image is quite technical and doesn't capture the disease well. What do talk page watchers think of bringing one of the MRI images up, or adding a slightly improved version of the myelin damage image? Improved with larger text size and damage that not only goes through the middle. In solidarity, —Femke (talk) 🐦 16:56, 14 September 2026 (UTC)

Edit request: citation for relapse unpredictability

I am a co-author of one of the sources below and am requesting this as an edit rather than making it myself.

Location: Signs and symptoms section, the sentence "Relapses are usually unpredictable, occurring without warning."

Proposed change (minimal): append one clause and one review citation, so the sentence reads:

Relapses are usually unpredictable, occurring without warning; in untreated patients the intervals between relapses have been found to be exponentially distributed, i.e. random rather than periodic.

The existing citations to Portaccio 2024 and Tafti 2024 should be kept. If editors also want the primary study behind the review's statement, it is Bordi et al. 2013 (doi:10.1155/2013/910321 {{doi}}: unflagged free DOI (link), PMID 23671846); I have not included it inline because WP:MEDRS prefers the secondary source on this article.

Rationale: the sentence currently states unpredictability without saying what kind; the review supplies a sourced, one-clause quantitative description. BlueFins2893 (talk) 20:02, 14 September 2026 (UTC)

That's a really cool study! I don't see a reference to the exponential distribution in the secondary source you gave. This quite technical term that is likely too detailed for an broad article like this. In solidarity, —Femke (talk) 🐦 20:17, 14 September 2026 (UTC)

Thanks Femke! The review surveys the stochastic-modelling work but does not itself state the exponential-distribution finding; that is only in the primary study. BlueFins2893 (talk) 01:02, 15 September 2026 (UTC)

References